Artikel
Standardised coagulation questionnaire for adenotomy and tonsillectomy in children
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Autoren
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Boris A. Stuck
- Department of Otorhinolaryngology, Head and Neck Surgery, Essen, Germany
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Maren Königstein
- Department of Otorhinolaryngology, Head and Neck Surgery, Mannheim, Germany
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Claudia Umbreit
- Department of Otorhinolaryngology, Head and Neck Surgery, Mannheim, Germany
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Ute Walliczek
- Department of Otorhinolaryngology, Head and Neck Surgery, Marburg, Germany
| Veröffentlicht: | 10. August 2015 |
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Gliederung
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Introduction: An interdisciplinary position paper on perioperative assessment of coagulation for children undergoing adenotomy / tonsillectomy (AT/TE) has been published in 2006. In this position paper, routine coagulation tests were no longer recommended and it was advised to use a standardized questionnaire for the assessment of potential coagulation disorders instead. Aim of the study was to assess whether the implementation of these recommendations has led to a change in the frequency postoperative bleeding after AT/TE in children.
Methods: A retrospective analysis was performed based on the charts of those children who underwent AT/TE in the years 2003 and 2009 and postoperative bleeding was assessed. While preoperative evaluation was based on general history in conclusion with routine blood test as needed in 2003, all children operated in the year 2009 were assessed with the standardized questionnaire only as recommended. In those cases were a coagulopathy was suspected based on the questionnaire, detailed laboratory testing was performed.
Results: In 2003, 293 children were operated and postoperative bleeding occurred in 20 cases (6.8%), 18 of those (6%) requiring surgical revision. In 2009, 352 AT/TE was performed in 352 children. Postoperative hemorrhage was reported in 25 children (7.1%) and 14 patients (4%) requiring surgical intervention. A statistically significant change in the frequency of postoperative bleeding was not detected. Routine preoperative blood tests were available in 5 children with postoperative bleeding in 2003 and were normal in all cases. In addition, detailed laboratory coagulation testing performed in those children with postoperative bleeding turned out normal in all cases assessed.
Conclusion: The use of a standardized coagulation questionnaire without routine coagulation tests did not lead to an increase in the rate of postoperative bleeding in children undergoing AT/TE. Moreover, the results support the idea that postoperative bleeding after AT/TE is usually not a result of a coagulation disorder.
